Performances of CYFRA 21-1, Carcinoembryonic Antigen and Their Combination for Lung Cancer Diagnosis

The neutrophil-to-lymphocyte ratio, CA19-9 and CEA in the diagnosis of pancreatic cancer / 中华肝胆外科杂志

Objective To study the neutrophil-lymphocyte ratio (NLR),CA19-9 and CEA in the diagnosis of pancreatic cancer (PC).Methods From January 2013 to June 2016,the data of 723 consecutive patients with pancreatic diseases were reviewed.Of these 723 patients,632 patients had PC (stage Ⅰ,Ⅱ 324 patients;stage Ⅲ,Ⅳ 289 patients),66 patients had pancreatic cystic tumors,and 26 patients had tumor-forming pancreatitis.The Receiver Operating Curve (ROC) and the logistic regression model were used to assess the blood biomarkers in predicting PC.Results Using the ROC,CA19-9 CEA,NLR,PLR,ALP,GGT,LDH,GLU and MONO# were useful in diagnosing malignant pancreatic diseases.Logistic regression analysis showed that CA19-9 (95％ CI:12.928 ～ 103.330;P ＜ 0.05),CEA (95％ CI:1.041 ～3.472,P＜0.05) and NLR (95％ CI:1.020～ 3.525,P =0.043) were independent variables in predicting PC.The concentrations of CA19-9,CEA,and NLR had the highest values in predicting PC.When CA19-9 was ＜37 kU/L,the concentrations of NLR and CEA had a high sensitivity and specificity (AUC =0.746,95％CI:0.675～0.816,P＜0.05) of 69.2％ and 73.6％,respectively.Conclusions The concentrations of CA19-9,CEA,and NLR had the highest prediction value for PC.When the level of CA19-9 was ＜37 kU/L,the combined use of NLR and CEA significantly improved the diagnostic specificity.

Analytical capability of flow cytometric bead array for lung cancer markers / 药物评价研究

Objective To appraise the analytical capability of flow cytometric bead array for lung cancer markers through the tests of limit of detection,relative standard deviation,specificity,methods comparation and linearity rang.Methods The limit of detection,relative standard deviation,specificity and linearity rang in detection of Carcinoembryonic antigen (CEA),cytokeratin 19 (Cyfra21-1) and neuron specific enolase (NSE) in serum were evaluated by flow cytometer.Western blotting method was ultilized to validate the specificity of antibody-antigen recognization.The interference of hemoglobin,three acyl glycerol and bilirubin on the detection of CEA,Cyfra21-1 and NSE was tested.Compared to electrochemiluminescence immunoassay,the relative error for flow cytometric bead array was assessed.Results Flow cytometric bead array demonstrated that the limit of detection was 1.71 pg/mL for CEA,3.97 pg/mL for cyfra21-1,and 2.27 pg/mL for NSE.The relative standard deviation for intra-assay and inter-assay were below 10％ and 15％,respectively.The pair of antibodies can defferentially recognize antigens.The measurement for CEACAM6,CK18,NSE appeared that there was no significant cross-talking reaction.Three acyl glycerol and bilirubin did not significantly interfere with the detection for serum samples.Hemoglobin of 500 ng/mL can significantly interfere with the detection of Cyfra21-1 (P ＜ 0.05) and NSE (P ＜ 0.05).The correlation coefficient between flow cytometric array and electrochemiluminescence immunoassay was 0.984 2 for serum CEA,0.962 2 for serum cyfra 21-1 and 0.982 0 for serum NSE.The linearity ranged from 355.76 pg/mL to 367.74 ng/mL for CEA,from 87.89 pg/mL to 107.8 ng/mL for cyfra21-1,and from 90.12 pg/mL to 86.07 ng/mL for NSE.Conclusion Flow cytometric array for lung cancer markers may be of use in clinical detection.

Treatment efficacy of capecitabine combined with transcatheter arterial chemoembolization for hepatic metastases after colorectal carcinoma resection / 中华肝胆外科杂志

Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.

Treatment efficacy of capecitabine combined with transcatheter arterial chemoembolization for hepatic metastases after colorectal carcinoma resection / 中华肝胆外科杂志

Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.

Pathologic Correlation of Serum Carcinoembryonic Antigen and Cytokeratin 19 Fragment in Resected Nonsmall Cell Lung Cancer

BACKGROUND: This study focused on the association between preoperative serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (Cyfra 21-1) levels and pathologic parameters in patients with resected non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: The records of 527 patients who underwent pulmonary resection of NSCLC were reviewed. The association between preoperative serum CEA and Cyfra 21-1 levels and variables that had p-values of less than 0.05 in a t-test or one-way analyses of variance was analyzed by multiple linear regression. RESULTS: The mean serum CEA and Cyfra 21-1 levels prior to surgery were 6.8+/-23.1 mg/dL (range, 0.01 to 390.8 mg/dL) and 5.4+/-12.3 mg/dL (range, 0.65 to 140.2 mg/dL). The serum CEA levels were associated with tumor (T) and lymph node (N) stage and histology. The serum Cyfra 21-1 levels were associated with T stage, tumor size, and histology. Multiple linear regression indicated that serum CEA levels were associated with T (T3/4 vs. T1: beta=8.463, p=0.010) and N stage (N2/3 vs. N0: beta=9.208, p<0.001) and histology (adenocarcinoma vs. squamous cell: beta=6.838, p=0.001), and serum Cyfra 21-1 levels were associated with tumor size (beta=2.579, p<0.001) and histology (squamous cell vs. adenocarcinoma: beta=4.420, p=0.020). CONCLUSION: Serum CEA level was correlated with T and N stage, and Cyfra 21-1 with tumor size. CEA and Cyfra 21-1 showed histologic correlation. CEA is mainly elevated in adenocarcinoma and Cyfra 21-1 in squamous cell carcinoma. These results might be helpful for predicting pathologic status in preoperative NSCLC.

Pathologic Correlation of Serum Carcinoembryonic Antigen and Cytokeratin 19 Fragment in Resected Nonsmall Cell Lung Cancer

BACKGROUND: This study focused on the association between preoperative serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (Cyfra 21-1) levels and pathologic parameters in patients with resected non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: The records of 527 patients who underwent pulmonary resection of NSCLC were reviewed. The association between preoperative serum CEA and Cyfra 21-1 levels and variables that had p-values of less than 0.05 in a t-test or one-way analyses of variance was analyzed by multiple linear regression. RESULTS: The mean serum CEA and Cyfra 21-1 levels prior to surgery were 6.8+/-23.1 mg/dL (range, 0.01 to 390.8 mg/dL) and 5.4+/-12.3 mg/dL (range, 0.65 to 140.2 mg/dL). The serum CEA levels were associated with tumor (T) and lymph node (N) stage and histology. The serum Cyfra 21-1 levels were associated with T stage, tumor size, and histology. Multiple linear regression indicated that serum CEA levels were associated with T (T3/4 vs. T1: beta=8.463, p=0.010) and N stage (N2/3 vs. N0: beta=9.208, p<0.001) and histology (adenocarcinoma vs. squamous cell: beta=6.838, p=0.001), and serum Cyfra 21-1 levels were associated with tumor size (beta=2.579, p<0.001) and histology (squamous cell vs. adenocarcinoma: beta=4.420, p=0.020). CONCLUSION: Serum CEA level was correlated with T and N stage, and Cyfra 21-1 with tumor size. CEA and Cyfra 21-1 showed histologic correlation. CEA is mainly elevated in adenocarcinoma and Cyfra 21-1 in squamous cell carcinoma. These results might be helpful for predicting pathologic status in preoperative NSCLC.

Evaluation of the UniCel(TM) DxI 800 Immunoassay Analyzer in Measuring Five Tumor Markers

PURPOSE: Tumor marker concentrations in a given specimen measured by different analyzers vary according to assay methods, epitopes for antibodies used, and reagent specificities. Although great effort in quality assessment has been instituted, discrepancies among results from different analyzers are still present. We evaluated the assay performance of the UniCel(TM) DxI 800 automated analyzer in measuring the alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA 15-3 and CA 19-9 tumor markers. MATERIALS AND METHODS: The linearity and precision performance of the five tumor marker assays were evaluated, and concentrations of the respective markers as measured by DxI were compared to those measured by other conventional analyzers (ADVIA Centaur(TM) and Vitros(TM) ECi) using 200 specimens collected from 100 healthy persons and 100 patients with respective cancers. RESULTS: The linear fits for all five tumor markers were statistically acceptable (F=4648 for AFP, F=15846 for CEA, F=6445 for CA 125, F=2285 for CA 15-3, F=7459 for CA 19-9; p<0.0001 for all). The imprecision of each tumor marker assay was less than 5% coefficient of variation, except for low and high concentrations of AFP. The results from UniCel(TM) DxI 800 were highly correlated with those from other analyzers. CONCLUSION: Our results demonstrate that UniCel(TM) DxI 800 has good linearity and precision performance for the tumor markers assayed in this study. However, there were discrepancies between assaying methods. Efforts to standardize tumor marker assays should be undertaken, and the redetermination of cut-off levels is necessary when developing methods of analyzing tumor markers.

Efficacy of Intraoperative Hyperthermic Peritoneal Perfusion on 60 Patients with Advanced Gastric Carcinoma / 中国肿瘤临床

Objective: To evaluate the efficacy of intraoperative hyperthermic peritoneal perfusion (CHPP) on advanced gastric carcinoma. Methods: Sixty patients with advanced gastric carcinoma were divided into the control group and the treatment group. All patients underwent radical gastrectomy and D2 node dissection. Patients in the treatment group received CHPP when surgical resection was completed. Patients in the control group underwent resection of gastric carcinoma without CHPP. Chemotherapy was administered with FOLFOX4 regimen intravenously for 12 cycles in both groups at 4 weeks after surgery. The serum Carcinoembryonic antigen (CEA) and CA19-9 were measured in patients with advanced gastric cancer before and after resection of tumor. Survival and recurrence in both groups were analyzed and compared. Results: The mean levels of the expression of CEA and CA19-9 in the peripheral blood of the 60 patients were significantly higher than the upper limits of normal (55.89±22.25μg/L vs 0～5μg/L; 125.35±61.78 U/mL vs 0～39U/mL P< 0.01). There were no significant differences in the mean levels of the expression of CEA and CA19-9 in the peripheral blood between the treatment group and the control group (54.67±22.95μg/L vs 56.09±22.15μg/L; 126.16±62.45 U/mL vs 123.35±60.88 U/mL,P>0.05). The serum CEA and CA19-9 levels were significantly decreased at 7 days after treatment in the treatment group (7.58±3.21 μg/L, 31.35±13.47 U/mL, P<0.01). The levels of these two tumor markers were decreased unremarkably at 7 days after treatment in the control group (37. 68±20.59μg/L, 98.23±36.28 U/mL, P>0.05). The serum CEA and CA19-9 levels were decreased significantly in both groups at 30 days after surgery (P<0.05). One-year survival and recurrence rates were 83.3% and 10% in the treatment group and 80% and 13.3% in the control group, with no significant differences between the two groups (P>0.05). Three-year survival and recurrence rates were 63.3% and 20% in the treatment group and 40% and 40% in the control group, with a significant difference between the two groups (P<0.05). Conclusion: Surgical resection combined with CHPP can significantly decrease the serum CEA and CA19-9 levels. Intraoperative CHPP for patients with advanced gastric carcinoma is helpful for preventing peritoneal metastasis and recurrence and can prolong survival time.

Enhanced CEA-specific Immune Responses by Tat-LLO Fusion Protein

BACKGROUND: Carcinoembryonic antigen (CEA) is well-known soluble tumor marker frequently detectable in peripheral blood of carcinoma patients and considered as good target for antigen-specific immunotherapy. However, it is known that the induction of immune response to CEA is very difficult because CEA is a self-antigen expressed in fetal cells and weakly expressed in normal colorectal epithelial cells. To enhance anti-tumor immunity specific for CEA, recombinant CEA protein was modified using listeriolysin O (LLO) for endosomal lysis and transactivator of transcription (Tat) domain for transducing extracellular proteins into cytoplasm. METHODS: After immunization using dendritic cells pulsed with Tat-CEA, both Tat-CEA and LLO, and both Tat-CEA and Tat-LLO, antibody titer to CEA and LLO, cytotoxic T lymphocyte activity and the frequency of IFN-gamma producing T lymphocytes were measured. RESULTS: Immunization using DC pulsed with both Tat-CEA and Tat-LLO protein showed the increasement of production of CEA-specific antibody in serum, cytotoxic T lymphocyte activity, the frequency of IFN-gamma secreting T cells, compared with DC pulsed with both Tat-CEA and LLO. Furthermore the ratio of CD8+ T cell to CD4+ T cell among CEA-specific T cells was increased in group pulsed with both Tat-CEA and Tat-LLO. CONCLUSION: These results suggested that DC vaccine using Tat-LLO could be used for the development of effective immunotherapy for the treatment of tumor.

CEA Expressions in Colorectal Tumor

PURPOSE: The purpose of this research is to investigate the clinical usefulness of carcinoembryonic antigen (CEA) expression in colorectal cancer tissue. METHODS: We performed immunohistochemical staining of CEA on 64 surgically resected colorectal cancer tissues obtained during the period from May 2000 to May 2001. CEA expression was detected by immunohistochemistry using a CEA monoclonal antibody. The degrees of CEA expression in the tumor cell cytoplasm and the luminal secretion of the tumor gland were grouped into positive (strongly positive) and negative groups (weakly positive) by using the Sinicrobe method and were compared with clinicopathological variables. RESULTS: The expression rates were positive in 38 cases (59.4%) and negative in 26 cases (40.6%). The preoperative CEA level showed a higher trend in the positive group (8.23+/-13.7) than it did in the negative group (17.89+/-38.7 ng/ml), but the difference was not statistically significant. The relationships between the CEA expressions of the two groups and the clinicopathologic factors were not statistically significant. We observed CEA expression in the luminal secretion of the tumor gland in 41 cases. The expression rates in the luminal secretion were positive in 21 cases (51.2%) and negative in 20 cases (48.8%). No significant clinical difference were noted between the two groups. CONCLUSIONS: The results suggest that CEA expression may not play a role as a prognostic factor for colorectal cancer.

Detection of Micrometastasis in Draining Vein before & after Manipulation and Peritoneal Cavity in Colorectal Cancer by Reverse Transcriptase-Polymerase Chain Reactions for Cytokeratin 20 and Carcinoembryonic Antigen

PURPOSE: Micrometastasis is known as a significant predictor of prognosis in colorectal cancer patients. Recently, reverse transcriptase polymerase chain reaction (RT-PCR) has been applied to detecting micrometastasis. The drainage vein and peritoneum were examined and the micrometastases assessed in a series of colorectal cancer patients. METHODS: 22 patients, who were histologically diagnosed with colorectal cancer, and 8 patients of serosal and peritoneal brushing, were examined using RT-PCR to amplify the mRNAs for two epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20). RESULTS: Among the 22 colorectal cancer patients, the positive rates of CK-20 and CEA mRNAs in the drainage vein were 10 (45%) and 7 (32%), and those of the serosal and peritoneal brushing were 6 (75%) and 5 (63%), respectively. CONCLUSION: These results suggest that the "no touch isolation technique" might be useful for operations in advanced colorectal cancer patients, and the brushing of the serosal or Douglas pouch can represent the micrometastasis status.

Use of RT-PCR for CK20 and CEA mRNA to Detect of Micrometastasis in the Draining Venous Blood and the Peritoneum in Gastric Cancer Patients

PURPOSE: The benefits of the "no-touch" isolation technique that is usually performed to prevent the circulation of tumor cells are not evident. The aim of this study was to determine whether the no-touch isolation technique for treating gastrointestinal cancers could prevent the circulation of tumor cells detected by reverse transcriptase polymerase chain reaction (RT-PCR). Matrials and Methods: By using RT-PCR to amplify mRNAs for two specific epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20), we examined 34 gastric cancer patients who had been histologically diagnosed and 22 patients had undergone serosal and peritoneal brushing. RESULTS: In 10 (29.4%) of the 34 gastric cancer patients, we detected CK20 mRNA before manipulation, and in 17 (51.5%) of those patients, after we detected it. The density of the CK20 mRNA band was increased in 11 cases (33.3%) and the density was decreased in 2 cases (6.1%). In 16 (48.5%) of the 34 gastric cancer patients, we detected CEA mRNA before manipulation, and in 17 (51.5%) patients after we detected it. The density of the CEA mRNA band was increased in 8 cases (24.2%) and decreased in 3 cases (9.1%). CONCLUSION: These result suggest that the "no-touch isolation technique" might be useful when operating on advanced gastric cancer patients and that serosal or Douglas pouch brushing can be used to determine the status of micrometastasis.

Use of RT-PCR for CK20 and CEA mRNA to Detect of Micrometastasis in the Draining Venous Blood and the Peritoneum in Gastric Cancer Patients

PURPOSE: The benefits of the "no-touch" isolation technique that is usually performed to prevent the circulation of tumor cells are not evident. The aim of this study was to determine whether the no-touch isolation technique for treating gastrointestinal cancers could prevent the circulation of tumor cells detected by reverse transcriptase polymerase chain reaction (RT-PCR). Matrials and Methods: By using RT-PCR to amplify mRNAs for two specific epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20), we examined 34 gastric cancer patients who had been histologically diagnosed and 22 patients had undergone serosal and peritoneal brushing. RESULTS: In 10 (29.4%) of the 34 gastric cancer patients, we detected CK20 mRNA before manipulation, and in 17 (51.5%) of those patients, after we detected it. The density of the CK20 mRNA band was increased in 11 cases (33.3%) and the density was decreased in 2 cases (6.1%). In 16 (48.5%) of the 34 gastric cancer patients, we detected CEA mRNA before manipulation, and in 17 (51.5%) patients after we detected it. The density of the CEA mRNA band was increased in 8 cases (24.2%) and decreased in 3 cases (9.1%). CONCLUSION: These result suggest that the "no-touch isolation technique" might be useful when operating on advanced gastric cancer patients and that serosal or Douglas pouch brushing can be used to determine the status of micrometastasis.

Induction of CEA-specific Cytotoxic T Lymphocytes by Murine Dendritic Cells Expressing CEA

BACKGROUND: Carcinoembryonic antigen (CEA) is well-known soluble tumor marker frequently detectable in peripheral blood of carcinoma patients and considered as good target for antigen-specific immunotherapy. In this study, we used a replication-deficient adenovirus containing CEA to study CTL induction in vitro after adenovirus-mediated gene transfer into DC. METHODS: DC were obtained from mouse bone marrow and cultured with IL-4 and GM-CSF. For measuring CTL activity, splenocytes were harvested from the mice, which were immunized with DC that had been infected AdV-CEA or pulsed with CEA peptide. Untreated DC was used as a control. Splenocytes were re-stimulated in vitro with DC pulsed with CEA peptide for 7 days and CTL activity with CEA peptide-pulsed EL-4 cells were assessed in a standard 51Cr-release assay. The frequencies of antigen-specific cytokine-secreting T cell were determined with mIFN-gamma ELISPOT. RESULTS: DC infected with recombinant adenovirus expressing CEA induced CEA-specific CTL responses in vivo. Splenocyte induced from mice immunized with AdV-CEA-infected DC increase in the number of IFN-gamma secreting T cells compared with those from mice immunized with CEA peptide-pulsed DC. CONCLUSION: These results suggested that DC infected with recombinant adenovirus has advantages over other forms of vaccination and could provide an alternative approach vaccination therapies.

Enhanced Induction of CEA Specific Tumor Immunity by TatCEA Fusion Protein

PURPOSE: The human carcinoembryonic antigen (CEA) is expressed in several tumor types, including colorectal cancer, and is a tumor-associated antigen used as a target for antigen-specific immunotheraphy. CEA is a self-antigen associated with development, expressed in fetal cells and rarely expressed in normal colorectal epithelial cells. The induction of immune response to CEA is very difficult. In this study, we attempted to increase the tumor immunity specific to CEA by using dendritic cells pulsed with fusion proteins of CEA and Tat (transactivator of transcription), which transduces extracellular proteins into cytoplasm and causes antigens to be presented with MHC class I pathway. METHODS: The Tat gene was amplified in the PNL4-3 HIV plasmid and then inserted into PCEP4 plasmid vector. The CEA gene was cloned from cDNA from LoVo human colorectal cell line and then amplified through polymerase chain reaction method. After cloning of PCEP4 plasmid vector, the dendritic cell was sensitized and internalized with CEA and Tat-CEA protein. Then the Western blot analysis of the expression of CEA in the gene-modified dendritic cell and the immunofluorescent staining of the expression of CEA in CEA or Tat-CEA-pulsed dendritic cell were performed. A detection of IFN-gamma-releasing CD8 cell and a cytotoxicity of T-cell were was assesed using ELISPOT assay. The Immunoglobulin (Ig) G isotypes were analyzed with enzyme-linked immunosorbent assay. The statistical significance was assessed using Students t-test. RESULTS: CEA pulsed in dendritic cells was distributed over the cell surface and TatCEA was observed in the cytoplasm. The cellular immune responses by immunization with dendritic cells pulsed with TatCEA (322/10(4) lymphocytes) were significantly increased compared with those with CEA (244/10(4) lymphocytes) by IFN-gamma ELISPOT assay (P<0.05). The cytotoxic T lymphocyte (CTL) activity using mouse T-cell, EL-4 pulsed peptide (EAQNTTYL) as target cells was 23.3+/-2.75% (E:T=1:100) in the CEA group and 22.9+/-2.23% (E:T=1:100) in the TatCEA group. In ELISA analysis of the IgG isotype, the titer of IgG2a and IgG3, representing Th1 immune response, was lower than that of IgG1, representing Th2 immune response, in both the CEA group and the TatCEA group. CONCLUSIONS: These results suggest that TatCEA could be used for the development of a tumor vaccine and cellular immunotherapy using CTLs induced in vitro.

Relationship between Carcinoembryonic Antigen (CEA) and Pulmonary Function in Middle-aged Male Smokers

BACKGROUND: Carcinoembryonic antigen (CEA) is a glycoprotein on cellular surface, which is highly condensed in embryonic tissue and tumor of various kinds. Previous study found out that CEA may grow with various cancer or other diseases other than cancer as well. Besides, it is widely known that smoking also influences the rise in CEA. Among the same smokers, some of them show high CEA figures in serum when others remain in normal range. There are those whose pulmonary function is not influenced by smoking when that of others are susceptible to it. Therefore, this study was undertaken with an aim to study the relationship between serum CEA and pulmonary function by investigating how the change in pulmonary function caused by smoking influences serum CEA. METHODS: From Nov, 1997 to Feb, 2001, this study carried out tests on adult male smokers ages 35 to 64 who visited a hospital located in Kang Nung city. The subjects were divided into two groups: one group of 29 subjects with high CEA with over 6.0 ng/ml with normal colon study; the other group, which is the CEA normal group, consisted of 58 subjects selected through age adjusted random sampling. Data on personal information, smoking and clinical history was collected from a questionnaire. CEA was tested using radioimmunoassay of Abott. Pulmonary function was examined using Analyzer assembly Vmax 20C from Sensormedics Company. These examinations was limited to those who have been screened not to have cancer by chest X-ray, abdominal ultrasonography, and duodenofibroscopy. RESULTS: Smoking per day for the group with high serum CEA was 1.3 pack ( 0.4 pack), which was found to be significantly higher compared to that of normal group (P<0.01). Pack-years with high serum CEA group was 32.6 13.5 which was also comparatively higher than that of the normal group with 22.4 10.9 (P<0.01). Pulmonary function test indicated that FEV1 for the group with high serum CEA was 3.0 0.5 L, which marked lower than that of the normal group with 3.4 0.5 L (P<0.05). After compensating for age and pack years, FEV1 decreased in proportion to the rise in CEA. CONCLUSION: This study has established a link between serum CEA and daily smoking, pack years, and pulmonary function and found that FEV1 was inversely proportionate to the rise in CEA regardless of corrected pack years and daily smoking. Consequently, serum CEA alone is thought to be related to the pulmonary function. Therefore, it is advised that smokers with high serum CEA need to take heed of the influence on pulmonary function.

The Significance of Perioperative Serum Carcinoembryonic Antigen Measurement in Patients with Curative Colorectal Cancer

PURPOSE: Regular monitoring of serum carcinoembryonic antigen (CEA) has been used as a tool to detect recurrence of colorectal cancer postoperatively. This study aimed to evaluate the significance of perioperative serum CEA level in patients with curative colorectal cancer. METHODS: We analyzed the data obtained from the 420 patients with colorectal cancer who underwent curative resection. Preoperative serum CEA level (ng/ml) was divided into 3 groups, i.e. groups I: or=20. Each group of preoperative serum CEA level was analyzed in accordance with location, histologic differentiation, stage of tumor, recurrence and survival. Postoperative serum CEA level was analyzed in accordance with preoperative serum CEA level and recurrence. RESULTS: Preoperative serum CEA level correlated with tumor stage (P=0.009). Ninety six patients among 420 patients showed recurred and recurrences were more common in patients with high preoperative serum CEA level (P =0.002). Systemic recurrences were more common in patients with high preoperative serum CEA levels than normal levels (P=0.029). In recurrence cases, 75 patients (78.1%) had elevated serum CEA levels and 55 patients had high preoperative serum CEA levels (P=0.008). The disease free 5-year survival rate in preoperative serum CEA group I, II, and III were 91.4%, 70.5%, and 58.3% respectively (P= 0.000) CONCLUSION: Preoperative serum CEA levels seemed to be closely correlated with distant metastasis and survival. Meticulous follow-up evaluation and generous use of adjuvant therapy are recommanded in patients with high preoperative CEA level.

Diagnostic value of the vascular endothelial growth factor in ascites / 中国实用内科杂志

Objective To study to the differential diagnostic value of the VEGF in ascites and to investigate the clinical significances of VEGF combined with CEA measurement.Methods The VEGF and CEA levels in ascites were measured by ELISA in 58 ascites specimens.Results The VEGF level in malignant ascites was significantly higher than that in nonmalignant ascites (P

Clinical Significance of Preoperative High Serum CEA Value in Patients with Colorectal Cancer

PURPOSE: The preoperative s-CEA level are correlated to the extent of the tumor and distant metastasis in patients with colorectal cancer. This study was performed to analyze patterns of distant metastasis and survival rate according to the levels of preoperative s-CEA and evaluate the significance of chest CT and bone scan as methods of preoperative staging work-up in patients with high s-CEA level (>or=20 ng/ml). METHODS: A retrospective study was performed on 1,136 colorectal cancer patients who underwent surgery in Asan medical center between 1989 and 1995. These patients were classified into 3 groups according to preoperative s-CEA level (group A: or=6,or=20). We scrutinized the patterns of metastasis and compared the survival rates between the groups. Another study was, then, conducted prospectively on the basis of the above results. One hundred and sixty nine patients with s-CEA level (>or=20 ng/ml) were routinely examined by chest CT and bone scan for preoperative metastatic work-up in addition to the conventional work-up. Statistical analysis was performed by chi-squared test, Kaplan-Meier and log-rank test. RESULTS: The preoperative s-CEA level and the tumor stages were significantly correlated (P=0.009). The distant metastasis rates in group A, B, and C were 22.7% (163/719), 49.1% (115/234), 76.5% (140/183), respectively (P=0.000). Five year survival rate of each group were significantly different in far advanced stage, stage III (0.71 vs. 0.61 vs. 0.51 : P=0.002) and stage IV (0.21 vs. 0.10 vs. 0.05 : P=0.004). In stage I and II, however, we couldn't find statistical differences. Among 169 patients with s-CEA level above 20ng/ml, 52 (30.7%) had liver metastasis. Twenty three patients (13.6%) had lung metastasis. Twenty (11.8%) cases of pulmonary metastasis were found on chest CT scan and 3 cases on chest X-ray or abdominal CT scan. Only 4 (2.4%) cases, however, had bone metastasis on bone scan. CONCLUSIONS: These results suggest that the high preoperative s-CEA level seemed to be closely correlated with distant metastasis and prognosis. A meticulous preoperative staging work-up including chest CT scan is recommended in patients with high preoperative s-CEA level.